CONCEALED HANDGUN LICENSE (CHL) INSTRUCTIONS TO APPLICANT Benton County Sheriff s Office APPOINTMENTS ARE REQUIRED to submit CHL applications - original and renewal. To schedule an appointment, call 541-766-6606. Appointments are available on Tuesdays and Thursdays: 11:30am 1:00pm at the Law Enforcement Center, 2 nd Floor, 180 NW 5 th Street, Corvallis ORIGINAL LICENSE: If you are applying for an original license, bring the following items 1. FEE: $65.00. Make your check out in the amount of $65.00 to the Benton County Sheriff s Office. Cash is also accepted; exact change required. This is the fee for a 4-year original license. 2. APPLICATION FORM. Must be completely filled out, legible and signed. 3. SIGNED REFERENCE SHEET. Have two character references complete and sign the Concealed Handgun License Required References form. 4. COPY OF DOCUMENT SHOWING PROOF OF COMPETENCY. See the reverse side for a list of ways to demonstrate competence with a handgun. 5. PROOF OF BENTON COUNTY RESIDENCY. Oregon Driver s License or document showing you currently lease or own property in Benton County or other document as described in ORS 166.291(9). 6. PROOF OF CITIZENSHIP. Birth certificate, passport or appropriate INS (Immigration and Naturalization Service) forms. 7. FINGERPRINTS. Your fingerprints will be taken during your application appointment. If you have recently been fingerprinted for your CHL, bring that fingerprint card with you. A picture of you will be taken when you turn in your completed application. RENEWAL LICENSE: If you are applying for a renewal license, bring the following items 1. FEE: $50.00. Make your check out in the amount of $50.00 to the Benton County Sheriff s Office. Cash is also accepted; exact change required. This is the fee for a 4-year renewal license. 2. APPLICATION FORM. Must be completely filled out, legible and signed. 3. PROOF OF BENTON COUNTY RESIDENCY. Oregon Driver s License or document showing you currently lease or own property in Benton County or other document as described in ORS 166.291(9). 4. PROOF OF CITIZENSHIP. Birth certificate, passport or appropriate INS forms. A picture of you will be taken when you turn in your completed application. NOTE: If you are renewing an EXPIRED license, you will also need to bring: Your expired Benton County Concealed Handgun License, and A signed Reference Sheet with two character references. BCSO 11-14.4-002 04.24.15, page 1 of 2
Concealed Handgun License Instructions to Applicant, continued PROOF OF COMPETENCE WITH A HANDGUN: You must be able to demonstrate competence with a handgun by any of the methods provided by law as follows: A. Completion of any NRA firearms safety or training course if handgun safety was a component of the course. B. Completion of any firearms safety or training course or class available to the general public offered by law enforcement, community college, or private or public institution or organization or firearms training school utilizing instructors certified by the NRA or a law enforcement agency if handgun safety was a component of the course. C. Completion of any law enforcement firearms safety or training course or class offered for security guards, investigators, reserve law enforcement officers or any other law enforcement officers if handgun safety was a component of the course. D. Present evidence of equivalent experience with a handgun through participation in organized shooting competition or military service. E. Is licensed or has been licensed to carry a firearm in this state, unless the license has been revoked. F. Completion of any firearms training or safety course or class conducted by a firearms instructor certified by a law enforcement agency or the NRA if handgun safety was a component of the course. [ORS 166.291] A number of local businesses offer firearms safety courses that meet this requirement and can be found through an internet search. The Benton County Sheriff s Office cannot recommend one course over any other. Additionally, the Oregon State Sheriff s Association (OSSA) has created an online class that meets this requirement and can be found at http://oregonchl.org/. CAUTION: Possession of a Concealed Handgun License does not authorize you to carry a firearm in any federal building, beyond the screening area in an airport, in a courtroom, jury room, judge s chambers or areas adjacent thereto, or any part of a courthouse where the presiding judge has posted notice of such prohibitions. If you are apprehended with a weapon on these premises, your Concealed Handgun License will be seized and returned to the Sheriff. BCSO 11-14.4-002 04.24.15, page 2 of 2
Benton County Sheriff s Office APPLICATION FOR LICENSE TO CARRY CONCEALED HANDGUN Original License $65.00 License Renewal $50.00 License Transfer $15.00 Change of Address, Lost or Stolen $15.00 Full Legal Name Last First Middle Other Names Used Last First Middle I hereby declare as follows: (Check each box that applies) PLEASE READ CAREFULLY I am a citizen of the United States. If I am not a citizen, I am a legal resident alien who can document continuous residence in Benton County for at least six months and have declared in writing to the Immigration and Naturalization Service my intention to become a citizen and can present proof of the written declaration to the Sheriff at the time of this application. I am now at least 21 years of age. I have NEVER been convicted of a felony. I have NOT within the last four years, been convicted of a misdemeanor. I have not been under the jurisdiction of the Juvenile Department in the last four years for committing an act involving violence, as defined in ORS 166.470, that if committed by an adult would constitute a felony or a misdemeanor. There are no outstanding warrants for my arrest, and I am not free on any form of pretrial release. I do not have any charges pending in any court resulting from an arrest or citation. I am not subject to a citation or court order restraining me from contacting or stalking another. I have not been convicted of a controlled substance offense or participated in court order drug diversion, with the exception of the combination of offenses outlined in ORS 166.291(L). I have not received a dishonorable discharge from the Armed Forces of the United States. I am not required to register as a sex offender in any state. I have not been committed to the Mental Health Services Division under ORS 426.130, nor have I been found mentally ill and presently subject to an order prohibiting me from purchasing a firearm because of mental illness. If any item above has NOT been checked, in order to qualify for a Concealed Handgun License you must be granted relief, or wish to petition for relief, from a disability under ORS 166.274 or ORS 166.293 or 18 USC 925(c), or those records have been expunged. Age Birthdate Birthplace State Social security number of the number is authorized under ORS 166.420. It will be used only as a means of identification. Disclosure of your social security number is voluntary. Solicitation Height ft. in. Weight Hair Color Eye Color Sex Current Address: Street City State Zip Phone ( ) Mailing address (if different) BCSO 11-14.4-003 1/4/13, page 1 of 2
APPLICATION FOR LICENSE TO CARRY CONCEALED HANDGUN (CHL), continued List residence addresses for the past three years if different from present address: Street City State Zip Street City State Zip List all states in which you have resided as an adult (18 years and older) I have read the entire text of this application, and the statements therein are true and correct. Making false statements on this application is a misdemeanor. I understand that I will be photographed and/or fingerprinted. Signature of Applicant: SPACE BELOW FOR OFFICIAL USE ONLY Proof of Identification: Two pieces of ID are required, one of which must bear the photograph of the applicant. Type Number Type Number Proof of Citizenship: Birth Certificate Passport Other: Competency with Handgun Documentation LICENSE APPROVED Approved Course Military Service Concealed Handgun License LICENSE DENIED BY: Date Issued Fee Paid License # Expiration Date BCSO 11-14.4-003 1/4/13, page 2 of 2
Benton County Sheriff s Office CONCEALED HANDGUN LICENSE REQUIRED REFERENCES (This reference sheet must be turned in with your application) Original License Two character references are required. Please have your references sign the statements and print their names and addresses in the indicated spaces below. Renewal License References are required if your license has expired. Applicant Name: I agree to be a character reference for the above individual and know of no reason why this license should not be issued. Signature: Print name and address: I agree to be a character reference for the above individual and know of no reason why this license should not be issued. Signature: Print name and address: BCSO 11-14.4-004 12/20/10